Diarrhea

1. Eat slowly and chew your food properly.
2. Reduce the amount of food you take each meal but increase the number of meals.
3. Avoid taking foods that cause diarrhea.
• Food with high fat content
• Strongly stimulating food (spicy food, coffee, alcohol, carbonated drinks, etc.)
• Fibrous food (konnyaku, mushrooms, seaweed, burdock, etc.)
  For leafy vegetables such as spinach, use the apex of the leaves. Cook radishes, carrots, turnips, etc. until they are soft before eating them.
4. If you are eating raw food, make sure it is fresh.
   As they reduce the secretion of gastric acids and weaken bactericidal action, it is necessary to be careful when eating raw food and food that is not fresh.
5. Take food that regulate the intestinal environment (such as yogurts containing lactic acid bacteria or lactobacillus bifidus, oligosaccharide, etc.).

Constipation

1. Take plenty of water.
2. Chew your food well and take an appropriate amount of dietary fiber. However, be careful as taking an excessive amount of hard dietary fiber can cause intestinal obstruction.
   Bananas do not cause irritation to the intestinal tract, making it an effective high-fiber food.
3. Aim to exercise moderately.
4. Aim to keep your meal times regular.
5. Go to the toilet if you feel the need to, and form a habit of moving your bowels.

Flatulence

1. If you do not chew your food properly, eat too quickly, or slurp your food, you will end up swallowing air. Be careful as this causes gases to build up.
2. Foods that generate gases
   Be careful of fatty foods and foods that are difficult to digest, such as chestnuts, sweet potatoes, yams, burdock, cabbage, cauliflower, various types of onions, beans, prawns, crabs, shellfish, ramen noodles, carbonated drinks, and beer.
3. Foods that inhibit the generation of gases
   Lactic acid beverages, yogurts, parsley, lemons, etc.
4. Strong-smelling foods
   Chinese chives, asparagus, various types of onions, garlic, cheese, prawns, crabs, shellfish, eggs, etc.
5. Foods that inhibit smells
   Parsley, lemon, orange juice, yogurt, etc.

Acid reflux/Heartburn

1. Reduce the amount of food you take each meal, and eat a little each time over a larger number of meals.
2. Keep your upper body upright for about 1 – 2 hours after meals, and avoid lying down immediately after meals.
3. When sleeping, keep your upper body slightly elevated.
4. Avoid taking fatty foods.
5. Take your dinner early and eat lightly, and avoid eating two hours before your bedtime.
6. When symptoms appear, drink a moderate amount of water at room temperature.

Early dumping

In early dumping syndrome, general symptoms and abdominal symptoms occur within 30 minutes after a meal. General symptoms include drowsiness, general malaise, cold sweats, and heart palpitations. Abdominal symptoms include abdominal distension, rumbling of the stomach, abdominal discomfort, and diarrhea.

1. Reduce the amount of food you take each meal, and eat a little each time over a larger number of meals.
2. Reduce the amount of water content in your food, and avoid washing down your food with liquids. Also be careful of eating boiled rice with tea (ochatsuke).
3. Chew your food well and eat slowly (30 minutes or more).
4. When symptoms appear, lie down to rest while keeping your head in an elevated position.

Late dumping

Late dumping syndrome refers to hypoglycemia that occurs about 90 minutes to three hours after a meal.

1. When any indication of late dumping syndrome appears, take something sweet quickly (such as candy, juice, or sugar cubes).
2. Bring along candy or sugar cubes when you go out so that you can feel reassured that you are prepared whenever it occurs.
3. If it occurs frequently, take foods with high sugar content about two hours after a meal.
4. When symptoms appear, take something sweet and lie down to rest while keeping your head in an elevated position.
• To video of workshop “Actual nutritional guidance given over time to patients after gastrectomy” (YouTube)
• To video of workshop “Food and nutrition” (YouTube)